In industrialized and developing countries, iron deficiency (ID) and iron deficiency anemia (IDA) are highly prevalent in pregnant women. ID and IDA, in pregnant women as a consequence of an increased iron requirement, due to enhanced blood volume and development of fetal-placenta unit, represent a high risk for maternal and infant health: preterm delivery, fetal growth retardation, low birth weight, and inferior neonatal health. However, the degree of fetal ID is not always as severe as that in mother, being iron transfer from the mother to the fetus regulated by the placenta. In particular, the placental syncytiotrophoblast acquires ferric iron bound to maternal transferrin at the apical membrane through transferrin receptors (TfR-1), which noticeably increase in pregnant women suffering of ID and IDA. Recently, it has been suggested that most iron transfer to the fetus, occurring after the 30th week of gestation, also involves placental expression of hepcidin and ferroportin, two proteins known to modulate systemic iron homeostasis in adults. As matter of fact, iron homeostasis is tightly regulated through iron absorption, storage and transport. The absorption of nearly all dietary iron (1-2 mg daily), ensuring iron supplies in the bone marrow, at second and third trimester of pregnancy increases until to about 4 and 8 mg/day, respectively. The iron absorption takes place in the proximal duodenum and includes the following steps: (i) reduction of iron from the ferric state (III) to the ferrous state (II) by a ferrireductase (duodenal cytochrome B; (ii) apical uptake by enterocytes followed by trans-cellular trafficking via divalent metal transporter 1; (iii) storage into ferritin; and (iv) basolateral efflux by the iron transporter ferroportin. Ferroportin, the only known cellular iron exporter from tissues into blood, has been found in all cell types involved in iron export, including the enterocytes, hepatocytes, placental cells and macrophages which require ferroportin to daily recycle 20 mg of iron from lysed erythrocytes for erythropoiesis.